Bandage Research Articles

Neural Network Model for Predicting Sub Bandage Pressure of High Compression Bandages

In this paper artificial neural network (ANN) model has been designed to predict the sub bandage pressure of high compression bandages during wrapping on the limb. Two different types of bandage fabrics (knitted and woven) were taken for the study. The other input parameters include bandage fabric type, circumference of limb, number of bandage layers, stretch% and width of the bandage. In order to reduce the dependency of the results on a specific partition of the data into training and testing sets, a threeway cross validation tests were performed, i.e. total data was divided into training and testing set in three different ways. The predicted sub bandage pressure was correlated to the experimental sub bandage pressure and correlation coefficient between the actual and predicted values obtained. It was observed that the neural network system is able to predict the sub bandage pressure after application with good correlation and less average error.

Prevention and treatment of chylous fistula after central lymph node dissection of thyroid cancer

Objective: To discuss the causes and effective measures of prevention and treatment of chylous fistula after central lymph node dissection (CLND) of thyroid cancer. Methods: A total of 6 127 patients who underwent CLND of thyroid cancer in the Tianjin Medical University Cancer Institute and Hospital between July 2013 and June 2015 were analyzed; of which, 14 patients acquired the complication of postoperative chylous fistula. The following conservative treatments were initially performed: systemic therapy, local pressure bandaging, normal pressure drainage, 50% glucose injection, or pingyangmycin injection through a drainage tube. Surgical op- eration was then conducted when the efficacy of the treatment was poor. Results: After the conservative treatment of the 14 patients, the drainage volume gradually decreased in 12 patients, and surgery was performed on the remaining two patients. Conclusion: The CLND of thyroid cancer must be carefully conducted to prevent postoperative chylous fistula. An active conservative treatment must

First experience of the surgical treatment of acute dislocation of clavicle acromial end

Over 100 methods of the surgical treatment of the dislocation of clavicle acromial end is known nowadays. Anatomic-biomechanic peculiarities of acromioclavicular joint and its ligamentous appa­ratus stipulate such a variety, at first, and secondly, this fact shows some disadvantages of every method. Moreover, it was defined, that complete restoration of function does not happen in 16.5–35.2 % cases. This fact shows the relevance of working out and implementa­tion of new treatment techniques. The goal: to improve the results of treatment of acromioclavicular joint injury using the restoration of coracoclavicular ligament with arthroscopic control. Methods: 5 patients (at the age from 18 to 42 years) with acute injury of ac­romioclavicular joint underwent an operation using arthroscopic equipment. The fixation of joint was carried out with «AKK rigging / АКК Такелаж» system in high-endurance nonabsorbable material. Immobilization duration in triangular bandage was equal to 2–3 weeks depending upon the severity of pain syndrome. Follow-up controls (clinical and radiographic assessment) were performed 1 and 3 months after surgery. Results: using of the method proposed for restoration of acute injures of acromioclavicular joint allowed to obtain good and excellent results in all patients after surgery. The range of motion in shoulder joint was restored in all patients completely. The proposed technique means surgery through little incisions (0.5 cm) that provide good cosmetic results. A positive feature of proposed technique is a minimal operation trauma, as far as you have not to expose a clavicle and subclavicular space for drilling it and fixator implementation. Conclusion: using of arthroscopic equipment for the restoration of acromioclavicular joint facilitates decreasing of operation trauma, terms of immobi­lization, allows predicting positive long-term results and restoring complete motion in shoulder joint.

Towards rationalisation of antivenom use in funnel-web spider envenoming: enzyme immunoassays for venom concentrations

Context: Funnel-web spider (Atrax and Hadronyche spp.) envenoming is rare but causes severe neuromuscular, autonomic, and cardiac effects. A rabbit-derived IgG antivenom is available, but venom detection in patients has not been reported. Objective: To use serial venom and antivenom concentrations to better define envenoming and antivenom effectiveness. Materials and methods: Serum was collected from nine patients with suspected funnel-web spider bites and clinical effects were recorded. Venom-specific enzyme immunoassays were developed to measure funnel-web spider venom and antivenom concentrations. Goat anti-rabbit whole serum was coupled to UltraLink resin and added to samples to remove bound venom and measure free venom. Antivenom efficacy was defined as antivenom binding all free venom and antivenom effectiveness as resolution of clinical features. Results: Venom was detectable in samples from six of nine patients. In three patients without venom detected, there were only moderate effects, which did not completely respond to antivenom in all cases and no spider was identified. In five of six cases, a male Atrax spp. (Sydney funnel-web) spider was identified. Three patients had moderate envenoming which responded to antivenom. Three patients had severe envenoming and developed catecholamine-induced myocarditis and acute pulmonary oedema. Although cholinergic and non-specific clinical features appeared to respond to antivenom, myocarditis and pulmonary oedema lasted 2–4 days. Median venom concentration pre-antivenom in five patients with samples was 5.6 ng/ml (3–35 ng/ml), and immediately post-antivenom decreased to a median of 0 ng/ml (0–1.8 ng/ml). Post-antivenom venom concentrations decreased when bound venom was removed; median, 0 ng/ml (0–0.9 ng/ml), indicating that most venom detected post-antivenom was bound. There was recurrence of venom and clinical features in one patient when a pressure bandage was removed. Conclusions: Detection of venom in suspected funnel-web spider bites identified definite cases with characteristic envenoming and a spider was identified. Measurement of venom concentrations pre- and post-antivenom demonstrated that venom was bound by antivenom, but in severe cases cardiac toxicity was not reversed.

Management and Outcomes of Cerebrospinal Fluid Leak Associated With Anterior Decompression for Cervical Ossification of the Posterior Longitudinal Ligament With or Without Dural Ossification

A retrospective clinical study. To analyze and evaluate the clinical outcomes of cerebrospinal fluid (CSF) leak after anterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL) with or without dural ossification (DO). Anterior decompression can be highly efficacious in the treatment of OPLL. However, in some cases of OPLL, there often exists DO and fusion with the posterior longitudinal ligament, which may increase the chance for CSF leak during an anterior decompression surgery. A retrospective analysis was performed on 126 OPLL patients (89 men and 37 women) treated with anterior decompression surgery between January 2008 and January 2012. The mean age at operation was 61 years (ranging from 46 to 72 y) and the average duration of diagnosis was 4.2 years (ranging from 3 d to 7 y). DO was present in 11 patients, of whom 7 developed dural tear or defect. Among the 115 patients without DO, only 4 developed dural tear. Intraoperative dural repair was performed with gelatin foam onlay and fibrin glue seal. Postoperative care for CSF leak involved bed rest, CSF drainage, nutritional support, and antibiotics. A total of 11 cases associated with dural tear or defect developed postoperative CSF leak (an overall incidence of 8.7%). There was a statistically significant difference (P<0.001) in the incidence of CSF leak between the DO group (63.6%) and the non-DO group (3.5%). While leakage in 3 patients resolved spontaneously within 5 days of surgery, intermittent CSF cysts developed in 8 patients. These were treated with circular pressure bandages, repeated aspiration, and lumbar drainage. All 8 cases resolved 14-30 days after surgery. These 11 patients were followed up for an average of 12.8 months (range of 1 to 36 mo) with an average Japanese Orthopedic Association score of 51.2% and no significant neurological deficit or persistent headaches were recorded. Patients with DO are at increased risk for dural injury while undergoing anterior decompression for the treatment of OPLL. This is associated with a high incidence of CSF leak. However, the majority of patients with CSF leak could be managed conservatively.

Perioperative nursing of huge malignant lobulated breast tumor

Objective To summarize the perioperative nursing of huge malignant lobulated breast tumor, so as to promote the recovery of patients. Methods A total of 11 patients with huge malignant lobulated breast tumor patients were selected, assessed the preoperative status,finished breast tumor site nursing, strengthen psychological nutritional assessment, the adjustment of the respiratory system for the operation, prevent falls. In addition to do a good job in general nursing and postoperative pain management, but should also focus on the observation of the chest wall flap, drainage tube care, to prevent bleeding and infection, etc. Results By implementing the nursing plan, 1 case of breathing difficulties preoperative patients with respiratory function improved, 1 case of refuse treatment of patients accepted surgical treatment after psychological intervention, 2 cases of postoperative patients with skin flap necrosis, local treatment, after compression bandage, 1 case of good recovery, 1 case of poor treatment effect for the wound recovered well after back surgery graft; 1 case of patients with subcutaneous effusion, to adjust the drainage tube, suction fluid, after compression bandage, partial treatment, recovering well. Patients were good recovery, discharged smoothly. Conclusions By constantly sum up experience, through positive assessment of patients after preoperative mental and physical health and attaches importance to patients' skin flap, bleeding, pain, completes the drainage tube nursing and prevention of infection, can effectively promote the recovery of patients. Key words: Breast neoplasms; Perioperative nursing

The art of bandaging safely and effectively

The art of bandaging safely and effectively

Robert Jones bandage pressure range assessment using a pressure mapping system and application to band calibration

The Robert Jones bandage (RJ) is a widely used bandage among veterinary surgeons to maintain physiological position of the limbs. It is a 3-layer composite bandage, which realization involves the use of several types of bands in a specific arrangement to give the bandage all its properties. Its proper making is difficult and requires experience, as the bandage needs to be not too tight or not too loose. This issue is a recurrent matter with every type of compression bandage (Rimaud et al. 2014). For the realization of a RJ, various types of bands can be used, depending on the surgeon but each layer has its own function that cannot be changed. The purpose of this study is to measure the pressure under a RJ bandage with a pressure mapping system and to evaluate the properties of some commonly used bands. The final application of these results is to propose a band calibration system to apply the correct pressure as a function of the band’s deformation.

Comparison between two early rehabilitation methods after total knee arthroplasty surgery

Objective To compare the effects of two early rehabilitation methods after total knee arthroplasty surgery. Methods A total of 40 patients after total knee arthroplasty surgery were randomly assigned to control group and experimental group on average. The control group conducted the conventional rehabilitation method, and the experimental group performed a method that patients used upper limbs doing active motion and passive motion of lower limbs with bandage. The patients were assessed by Hospital for Special Surgery (HSS) Knee Score at 1 week, 1 month and 3 months after the operation. The range of motion at 1 week and pain at 3 days were evaluated. Results At 1 week, 1 month and 3 months follow-ups, the HSS scores in the experimental group were (63.90±2.10), (71.65±2.50), (73.80±2.80) points, significant better than those in the control group (t=6.782, 4.547, 9.128; P<0.01). The rang of motion at 1 week and pain during rest at 3days follow-up in the experimental group were significantly better than those in the control group (t=16.644, -4.613; P<0.01). Conclusions The new rehabilitation method can help to accelerate the recovery of knee function, improve the quality of life and consolidate the clinical outcomes. Key words: Rehabilitation nursing; Arthroplasty, replacement, knee; Function exercise

Comparison between two methods of bandaging and hemostasis for puncture point after coronary intervention through radial artery

Objective To investigate the efficiency of chitosan hemostatic dressing combined radial artery hemostasis device in patients after transradial coronary intervention. Method Six hundred consecutive patients after transradial coronary intervention were selected and randomly divided into the experimental group and the control group according to the hospital number, there were 300 cases in each group. Single pneumatic tourniquet was used in the control group, while the chitosan hemostatic dressing combined with pneumatic tourniquet was used in the experimental group. Hemostasis consumption time, incidence of bleeding, ecchymosis and radial arterial occlusion were compared between two groups. Results There was no significant difference in the incidence of skin ecchymosis between two groups,P>0.05. The hemostasis consumption time and the incidence of bleeding,early radial arterial occlusion and chronic radial arterial occlusion were (127.6±33.0)min, 7.0%(21/300), 5.7%(17/300), 4.0%(12/300)in the experimental group and (181.6±32.2)min, 20.0%(60/300), 11.7%(35/300), 9.0%(27/300)in the control group,t or χ2 values were 20.258, 21.708, 6.822, 6.170 respectively, and there were significant differences,P<0.01 or <0.05. Conclusion In patients after transradial coronary intervention, the application of chitosan hemostatic dressing combined with pneumatic tourniquet is safer and more effective than using pneumatic tourniquet alone. Key words: Chitosan; Radial artery; Hemostatic techniques; Treatment outcome

Application of simulator first aid skills training in disaster medical rescue

First aid skills are very important in the process of disaster medical rescue methods. Some first aid skills is rarely applied in clinical work at ordinary times, resulting in relevant medical personnel grasp of these skills being not enough skilled. This training method combined with the simulator, has the characteristics and advantages of being close to the real, operational and repeatable. The main training program consists of 6 basic skills such as ventilation, hemostasis, bandaging, fixing, handling, basic life support. By simulating the real disaster scenario and simulation cases, we have targeted a single first aid skills training and multiple comprehensive ability training of first aid skills to trainees. To evaluate the training effect we have examined the individual skills of our trainees, with excellent performance as the goal, and in the comprehensive skills ability assessment we have paid attention to the emergency team's team cooperation ability. By the application of comprehensive simulation training and evaluation, the trainees can master all kinds of first aid skills in a short period of time. Key words: Disaster medicine; First aid skills; Simulator; Training; Examination

Application of 3M transparent dressing joint 3MTM CavilonTM No Sting Barrie Film in the skin care after peripherally inserted central catheter

Objective To evaluate the skin protection of the 3M transparent dressing joint 3MTM CavilonTM No Sting Barrie Film after peripherally inserted central catheter (PICC). Methods A total of 120 PICC catheter patients with lung cancer (observation time last about 3 months from starting the rearing pipe on the day to pipe-taken) were selected. They were divided into 2 groups by random digits table method with 60 cases each. Control group was given 3M transparent dressings stick in the PICC fixed place skin. Observation group was given 3M transparent dressings paste joint 3MTM CavilonTM No Sting Barrie Film. The incidence of complications in the PICC fixed place skin were observed and compared between 2 groups. Results The skin allergy, phlebitis, skin damage, total complications were 5, 4, 1, 10 cases in control group after PICC catheter and 2, 1, 3, 6 cases in observation group, and there was significant difference in the incidence of the total complications, χ2=4.23, P<0.05. Conclusion Using 3M transparent dressings joint 3MTM CavilonTM No Sting Barrie Film for skin care after PICC catheter, can effectively protect the skin after PICC catheter, reduce the incidence of adverse reactions. Key words: Catheterization, central venous; Phlebitis; Skin; Nursing care; Bandages

Cyanoacrylate tissue glue for wound repair in early posttrabeculectomy conjunctival bleb leak: a case series.

We demonstrated a noninvasive management of early bleb leak following trabeculectomy using cyanoacrylate tissue glue (CATG). Three patients who underwent augmented trabeculectomy with mitomycin C with early bleb leak between January 2009 and June 2010 were reviewed. Case 1 and Case 2 exhibited bleb leak on postoperative Day 1 and Case 3 showed leak on follow-up at postoperative Day 7. Case 1 was successfully sealed with CATG at postoperative Day 3, after failed pressure padding and bandage contact lens. Case 2 was successfully sealed with CATG at postoperative Day 3, after failed pressure padding and conjunctiva flap resuturing. In Case 3, the leaking conjunctival flap was managed with combined techniques of resuturing and applying CATG at postoperative Day 9, after failed pressure padding. During leakage, the intraocular pressure was low (6–8 mmHg) in all three cases, with shallow anterior chamber depth and absence of other complications such as choroidal detachment, hypotony maculopathy, or endophthalmitis. Foreign body sensation was the main complaint following the procedure. No clinical allergy reaction was documented. CATG may serve as a potential adjunctive and effective method in the management of posttrabeculectomy early bleb leak.

Amniotic membrane plugging and covering combined with bandage contact lens for the treatment of corneal perforation

Objective To study the clinical efficacy of human amniotic membrane plugging and covering combined with therapeutic bandage contact lens for the treatment of corneal perforation. Methods Fourteen eyes of 14 cases with corneal perforation induced by various causes were studied. All patients received surgical treament. The surrounding tissue of corneal perforation was cleared, then the multilayer amniotic membrane was filled into the site of perforation, and a slightly larger fresh amniotic membrane was covered and sutured on the perforated area immediately. Then, all patients weared the therapeutic bandage contact lens immediately and were bound up with pressure after surgery. The follow-up was 12 months. Results After 3 days, the anterior chamber formed. After 3 months, all amniotic membranes were absorbed, perforation was repaired, scar formed, and the vision had certain promotion. Conclusion Amniotic membrane plugging and covering combined with the therapeutic bandage contact lens is a simple and practical method for treatment of corneal perforation. Key words: Corneal perforation; Amniotic membrane; Contact lenses, bandage, therapeutic

The application of Comfeel hydrocolloid in skin protection of patients with fecal incontinence

Objective To observe the application of Comfeel hydrocolloid in skin protection of patients with fecal incontinence. Methods 100 patients with fecal incontinence but with intact skin were randomly divided into the control group and the observation group with 50 cases in each group. The control group adopted the tannic acid ointment treatment, the observation group used Comfeel hydrocolloid processing method. The occurring time, damaged area and degree of crissum skin damage were compared between two groups of patients. Results The happening time of crissum skin damage in the observation group was later than that of the control group [(3.31±0.13) d vs. (1.06±0.83) d,t=5.70], the damaged area was smaller [(6.86±1.83) m2 vs. (3.56±0.18) m2,t=5.94], and the incidence rate of crissum skin damage was lower [30%(15/50) vs. 100%(50/50), χ2=14.74]. Conclusions Comfeel hydrocolloid can effectively prevent the happening of the patients with fecal incontinence skin lesions, relieve patients' pain and promote disease rehabilitation. Key words: Bandages, hydrocolloid; Fecal incontinence; Skin care

Performance of drainage through micropores in the treatment of axillary osmidrosis with subcutaneous trimming

Objective To evaluate the performance of drainage through micropores in the treatment of axillary osmidrosis with subcutaneous trimming. Methods Forty-eight patients with axillary osmidrosis were enrolled in this study, and treated by subcutaneous trimming. After removal of apocrine sweat glands and hair follicles, a scalpel was used to cut several micropores（measuring 3 mm in length）along dermal ridges in skin flaps. Then, drainage was carried out through the micropores. Subsequently, the incisions were sewed up with 3-0 sutures followed by compression bandaging with elastic bandages. Dressings were changed and incisions were examined at 24 hours after operation, and bandages were taken off and skin flap viability was evaluated at 10 days. All the patients were followed for 3 months. Results After treatment, sweating was decreased and axillary odor disappeared in all the patients with a return to normal social activities. No obvious scar formed. Conclusion Drainage through micropores performs well in the treatment of axillary osmidrosis with subcutaneous trimming. Key words: BROMIDROSIS; Drainage; Surgical procedures, minor; Surgical flaps; Drainage through micropores

More than just a bandage

More than just a bandage

A flexible and low power telemetric sensing and monitoring system for chronic wound diagnostics.

BackgroundNon-healing chronic wounds, such as venous leg ulcers, can be monitored non-invasively by using modern sensing devices and wireless technologies. The development of such a wireless diagnostic tool may improve chronic wound management by providing evidence on efficacy of treatments being provided. This paper presents a low-power portable telemetric system for wound condition sensing and monitoring. The system aims at measuring and transmitting real-time information of wound-site temperature, sub-bandage pressure and moisture level from within the wound dressing.MethodsCommercially available non-invasive temperature, moisture, and pressure sensors are interfaced with a telemetry device on a flexible 0.15 mm thick printed circuit material to construct a light-weight, non-invasive, biocompatible, and low-power sensing device. The real-time data obtained is transmitted wirelessly to a portable receiver which displays the measured values. The performance of the whole telemetric sensing system is validated on a mannequin leg using commercial compression bandages and dressings. A number of trials on a healthy human volunteer are performed where treatment conditions were emulated using various compression bandage configurations.ResultsA reliable and repeatable performance of the system is achieved under compression bandage and with minimal discomfort to the volunteer. The system is capable of reporting instantaneous changes in bandage pressure, moisture level and local temperature at wound site with average measurement resolutions of 0.5 mmHg, 3.0% RH, and 0.2°C respectively. Effective range of data transmission is 4–5 m in an open environment.ConclusionsA flexible and non-invasive sensing system is developed to acquire and wirelessly transmit wound parameters from within a compression bandage and wound dressing worn on a human limb. Pre-clinical results on a healthy human subject suggest its clinical usability and value to health practitioners. However, further performance evaluations of the device on a wider population of healthy human subjects and on patients with chronic wounds are required to confirm its medial usefulness and to quantify its real impact on chronic wound management.

Application of exposed therapy in wound nursing after the skin flap transplantation for lower extremity injury

Objective To explore the effect of exposed therapy in wound nursing after the skin flap transplantation for lower extremity injury. Methods During January and August 2012, forty three patients, who underwent skin flap transplantation for the lower extremity injuries with soft tissue defect and whose wounds were bandaged using conventional gauze bandaging therapy, enrolled as control group. From September 2012 to April 2013, forty two patients with lower extremity injuries applied the exposed therapy when wound dressings were removed during 6 to 8 hours after surgery after skin flap transplantation as intervention group. This study aimed to evaluate the effect of conventional bandage therapy and exposed therapy by conducting the comparisons on blood circulation of transplantation flap, flap survival rate, wound infection and medical cost. Results The color, swelling and filling degree of transplanted flap in the intervention group were better than those in the control group (Z=5.63, 6.47, 6.48, respectively; P<0.01). The rate of flap normal temperature and flap survival rate were 83.33% and 97.62% in the intervention group, higher than those in the control group (χ2=7.40, 5.91, respectively; P<0.05). The wound infection rate was lower in the intervention group than that in the control group (Z=5.29; P<0.01). The data of intervention group were lower than those in the control group at medical cost, hospitalized days, switching medicine times and length of nursing (t=2.44, 32.78, 22.44, respectively; P<0.05). Conclusions For patients with skin flap transplantation, exposed therapy can effectively reduce the incidence of wound infection, and facilitate the direct observation of the flap blood circulation and the early detection of vascular crisis, so as to adopt the effective measures to prevent vascular crisis and improve the survival rate of skin flap. Key words: Skin flap transplantation; Wound nursing; Exposed therapy; Flap vascular crisis

Celox-coated gauze for the treatment of civilian penetrating trauma: a randomized clinical trial.

Background:Uncontrolled hemorrhage is a well-recognized cause of mortality in trauma victims and the control of active hemorrhage is among the initial steps in resuscitation.Objectives:The purpose of this study was to assess the role of a hemostatic agent “celox” in the management of civilian stab-wound trauma.Patients and Methods:In this clinical trial study, 160 patients with penetrating limb trauma were randomly allocated to either the control or intervention group (n = 80, each group). Controls were treated with the simple pressure dressing, while the celox-coated gauze was used in the intervention group. The time for achievement of hemostasis and the amount of bleeding were recorded. Data were analyzed using SPSS Version 21 and Stata 13. A P value of less than 0.05 was considered statistically significant.Results:The mean age of participants was 30.5 and the majority of patients were male (90.6%). The forearm and distal leg were the most sites of injury. Hemostasis was achieved within 5 minutes in 32.5% of the control group and 51.3% of the intervention group. Using the celox-coated gauze significantly reduced the time to hemostasis (P = 0.01). Moreover, the blood loss was significantly lower in the celox group compared to the controls (P < 0.05).Conclusions:Using the celox-coated gauze is able to achieve hemostasis in penetrating limb trauma faster than the conventional pressure bandage. Further research is required to clarify the subset of patients who will benefit the most from this effect in the emergency department.